Medical Policies

Medical policies

Reimbursement Guidelines - Categorical Index

Reimbursement Guidelines

Reimbursement

Advanced Illness / Advance Directives

Ambulatory Surgical Center (ASC) Reimbursement

Anesthesia, Professional and Facility

Bundling Guidelines

Co-surgeon, Assistant Surgeon, and Assistant-at-Surgery Guidelines

Consistency Guidelines

Developmental Delay Screening and Testing Guidelines

Diagnosis Validity & Code Guidelines

Discontinued Procedures

Documentation Requirements for Treatment of End Stage Renal Disease

Drugs and Biologicals

ECG Reimbursement

Evaluation and Management Services

Facility Billing Guidelines

Group Visit (Shared Medical Appointment) Guidelines

Guidelines for Global Maternity Reimbursement

Immunization Guidelines

Inpatient Readmission

Interfacility Transfer

Maximum Units of Service

Modifier Guidelines

Multiple Procedure Payment Reduction on the Technical Component (TC) of Diagnostic Cardiovascular and Ophthalmology Procedures

Multiple Surgical Procedure Guidelines for Professional Providers

NDC

Nonpayment for Serious Adverse Events

Once in a Lifetime

Opioid Treatment Program Reimbursement

Outpatient Code Editor (OCE) Edits

Partial Hospitalization and Intensive Outpatient Programs

Place of Service

Preadmission and Preoperative Services

Pricing and Adjudication Principles

Radiation Therapy Services

Radiology Services Reimbursement Policy

Reduced Services

Removal of Impacted Cerumen

Revenue Codes Requiring Procedure Codes, Facility

Services Bundled Into Inpatient / Outpatient Stays

Split Surgical Package

Supply and Equipment Reimbursement

Telehealth

Unplanned Return Surgery